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Bone marrow test

Read about bone marrow tests, what they are and what happens when you have one. 

You have this test to check whether there are cancer cells in your bone marrow. Bone marrow is spongy tissue and fluid that is inside your bones. It makes your blood cells.

A doctor or specialist nurse removes a sample of bone marrow cells or an area of bone marrow in one piece. This is usually from your hip. Doctors can then look at the cells or tissue under a microscope.

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You have the test in the outpatient department of the hospital. 

You have a local anaesthetic to numb the area. This means you are awake, but the test shouldn't be painful.

Why you might have a bone marrow test

Bone marrow tests are usually done for cancers that are most likely to affect the bone marrow, such as:

  • lymphomas
  • leukaemias
  • myeloma

But it can be done for any type of cancer if your doctor thinks your bone marrow could contain cancer cells, or needs to rule this out for any reason.

Types of biopsy

There are 2 main types of bone marrow test – a bone marrow aspiration and a bone marrow trephine biopsy.

Aspiration means the doctor or nurse sucks some bone marrow cells up into a syringe.

A bone marrow trephine means that they remove a 1 or 2cm core of bone marrow in one piece.

You usually have both of these tests done at the same time. They give some of the same information to the doctor, but there are differences. The bone marrow trephine shows the structure of the bone marrow inside the bone, whereas the aspiration takes just the bone marrow cells.

What happens

Your doctor will ask you to sign a consent form once they have given you information about the procedure. This is a good time to ask any questions you have.

You usually lie on your side with your knees tucked up into your chest. Your doctor or nurse cleans the area with some antiseptic fluid. This can feel cold.

You have a local anaesthetic injection into the skin over the biopsy site to numb it. When this has worked your doctor or nurse puts the needle in through the skin. It goes into the centre of the bone, where the marrow is.

Your doctor or nurse sucks a small amount of liquid bone marrow into the needle, using a syringe. You feel a pulling sensation when they start drawing the bone marrow cells out but some people have a sudden, sharp pain.

The doctor or nurse will take this needle out and put the second one in if you are having a trephine biopsy as well. The aim is to get a small amount of marrow out in one piece.

The needle going into the hip bone can be painful but this only lasts a short time. The whole test takes 15 to 20 minutes.

Sedation

Some people prefer to have some type of sedative before the test so that they are a bit drowsy. Some hospitals may use gas and air (Entonox) to help relax you instead of sedation.

 Children and teenagers often have sedation for this type of test.

After your bone marrow aspiration

If you have a sedative, you need to stay at the hospital for a few hours until it has worn off. And you need someone with you so that you don't have to go home on your own.

You can go home that day if you are feeling well enough.

You have a dressing over the site, which you should keep on for 24 hours. If you notice any bleeding apply pressure to the area. If it doesn't stop, contact the hospital.

After the test, your hip might ache for a couple of days. You may need some mild painkillers such as paracetamol to take at home.

Possible risks from bone marrow test

A bone marrow test is very safe and any risks are small. 

During the procedure there is a very small risk of damage to nearby structures but this is very rare.  

Bleeding

Some people have a small amount of bleeding from the area where the needle went in. If you are taking medicines to thin your blood, such as warfarin, you might need to stop taking these before the test. Your doctor will advise you when and how long to stop taking them.

You will have a dressing over the area which you should keep on for 24 hours. If you notice any bleeding, apply pressure to the area. If it doesn't stop, contact the hospital.

Infection

There is a small risk of getting an infection in the wound. Tell your doctor if you have a temperature or if the area becomes red and sore. 

Getting your results

Waiting for test results can be a very worrying time. You can contact your specialist nurse if you are finding it hard to cope. You can also get in touch with them to ask for information if you need to. It can also help to talk to a close friend or relative about how you feel.

For support and information, you can call the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday.

More information

We have more information on tests, treatment and support if you have been diagnosed with cancer.

Last reviewed: 
13 Apr 2015
  • The Royal Marsden Manual of Clinical Nursing Procedures, 9th Professional Edition
    L Dougherty and S Lister (Editors)
    Wiley-Blackwell, 2015

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